CHOICES ARE AWESOME - TRANS HEALTH CARE
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CHOICES ARE AWESOME - TRANS HEALTH CARE
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PLANS/PROGRAMSIncome Limit/Ages CoveredPhoneNotesEstrogenTestosteroneTop SurgeryBottom SurgeryCounseling
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CHiP - PENNSYLVANIA LAWMAKERS CURRENTLY TRYING TO CUT THIS FUNDINGChildren and Teens through age 18. Free or subsidized depending on income and family size. Gender Transition: Federal Final Rule “Nondiscrimination in Health Programs and
Activities” prohibits discrimination of the basis of sex in health-related insurance and
other health-related coverage. Coverage related to gender affirming services that
otherwise fall within the beneficiary’s scope of covered CHIP benefits (e.g. physician’s
services, inpatient and outpatient hospital services, surgical services, prescribed drugs,
therapies, etc.) will be compensable under the CHIP program when deemed medically
necessary. Medical necessity is to be determined utilizing the World Professional
Association for Transgender Health (www.WPATH.org) Standard of Care guidelines
and any successor WPATH guidelines. Sex specific health care cannot be denied or
limited because the person seeking services identifies as belonging to another gender.
For example; a provider may not deny an individual gynecological services such as pap
smears based on identification as a transgender male." CHiP April 5, 2017
1-800-986-KIDS (5437)Apply online at http://www.compass.state.pa.us/Yes if deemed medically necessary.Yes if deemed medically necessary.Yes if deemed medically necessary but see *.Yes if deemed medically necessary but see *.Yes. Providers who belong to Magellan Behavioral Health Services . **WPATH recommends surgery after age of consent reached = 18 in Pennsylvania, so this may be an issue. Parental consent -
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Medicaid - Medical AssistanceAge 19-64, Under 133% of the Federal Poverty Level = $15,800 for a single person, add approx. $6,000 per person for other family sizes. "Services related to gender transition that otherwise fall within a beneficiary’s scope of
covered MA benefits (e.g., physician’s services, inpatient and outpatient hospital services,
prescribed drugs) will be compensable under the MA Program when medically necessary. In
determining medical necessity for gender transition services, the Department and Managed
Care Organizations (MCO’s) will use the World Professional Association for Transgender
Health (WPATH) Standard of Care as guidelines and any successor WPATH guidelines to
determine whether the services are medically necessary. " PA Dept Human Services July 2016
866-550-4355 Apply online at http://www.compass.state.pa.us/Yes if deemed medically necessary.Yes if deemed medically necessary.Yes if deemed medically necessary.Yes if deemed medically necessary.Yes.
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ACA Plans (Obamacare)Subsidies reduce cost at certain income levels. "Marketplace plans sold through HealthCare.gov CAN NO LONGER:
• REFUSE TO INSURE transgender people
• HAVE EXCLUSIONS that deny all transition-related care
• DENY COVERAGE solely because you are transgender
• LIMIT ACCESS to “sex-specific” services (like hysterectomies or prostate exams)
based on sex assigned at birth, gender identity, or gender marker These new protections are key, but you may
still have to fight for your right to health care." www.out2enroll.org
211 - make appointment with a health insurance navigator near you. Other ACA navigator resources: Consumer Health Coalition: 412-456-1877
PA Health Access Network: 1-877-570-3642
https://www.healthcare.gov/transgender-health-care/YesYesYesYesYes
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PROVIDERS (selection)
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ProviderPhone/AddressWebsitePlans/ProgramsServices
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Metro Community Health Center1789 South Braddock Avenue #410, Pittsburgh, PA 15218 412-247-2310www.metrocommunityhealthcenter.orgSliding scalePrimary Care, Gynecology, Hormones
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Planned Parenthood of Western PAMultiple locations - Downtown is at 933 Liberty Ave., Pgh 15222, 412-434-8971www.ppwp.orgMedical Assistance, Family Planning Services, Adagio, ACA - Most Major Health Insurance PlansGynecology
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Persad Center5301 Butler St. Suite 100, Pgh 15201 412-441-9786www.persadcenter.org"PERSAD participates in the PA Medicaid program (CBH). You may qualify for funding available through our community partnerships."Counseling, Psychiatrist for Persad Counseling Patients, Referrals
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Central Outreach Wellness Center(412) 471-9806
1860 Centre Ave #106
Pittsburgh, PA 15219
http://www.centraloutreach.comAll Medical Assistance, Funding for Low-Income Allegheny Residents"Comprehensive Transgendered Health Care"
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OTHER RESOURCES/INFO
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Transgender Health Insurance Guide to the Marketplace (Obamacare Coverage)https://out2enroll.org/out2enroll/wp-content/uploads/2016/12/O2E_TransFlyer_Jan2017_Pennsylvania.pdfInfo for 2017 plans, will hopefully be updated for 2018 plans.
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Plan Details - Transgender Health Insurance Guide to the Marketplace (Obamacare Coverage)https://out2enroll.org/out2enroll/wp-content/uploads/2016/12/Pennsylvania-Plan-Documents.pdfInfo for 2017 plans, will hopefully be updated for 2018 plans.
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Out2Enrollhttps://out2enroll.org/Marketplace (Obamacare) enrollment help
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PA Health Law Projectwww.phlp.orgLegal Representation, Enrollment Help
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Transbuckethttp://www.transbucket.com/
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Pittsburgh Health Brigade - Providers Reviewed and Tagged Transgenderhttps://pittsburghhealthbrigade.wordpress.com/tag/transgender/
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Project Silk801 Penn Ave, Pgh 15222 Twitter FacebookDrop in center for LGBT youth of color for STD/HIV prevention, counseling, socializing.
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Proud Havenwww.proudhaven.org5132 Butler St. Pgh 15201 412-953-4666Helps homeless LGBTQ+ youth find housing and other services.
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Garden of Peace http://www.gardenofpeaceproject.org/qtpoc-resource-guide.htmlQueer Trans POC Resource Guide
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(412) 404-4000
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117 North Negley Avenue
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Pittsburgh, PA 15206
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